A needed push to protect state's infants

Minnesota health commissioner should add congenital cytomegalovirus to newborn screening program.

January 17, 2022 at 12:00AM
Newborns rest in the nursery of a postpartum recovery center in Kiryas Joel, N.Y. (Seth Wenig, Associated Press/The Minnesota Star Tribune)

Minnesota is admirably poised to take a pioneering step forward to help babies born with an underrecognized virus get the medical care they need.

State Health Commissioner Jan Malcolm should heed the recent guidance from a key advisory committee and add congenital cytomegalovirus to the list of disorders screened for in a spot of blood taken from newborns' heels.

Cytomegalovirus is often referred to by its acronym, CMV. More than half of American adults are infected with it by age 40, according to the U.S. Centers for Disease Control and Prevention (CDC). The immune system usually keeps the virus in check, meaning most healthy people don't feel ill or know they've been infected.

But infection is a serious concern when an expectant mother is infected or reinfected and passes the virus on to her developing child. Congenital CMV can have serious short-term health effects, such as seizures, retinal damage and microcephaly. Long-term effects include hearing and vision loss, along with developmental and motor delays.

Adding CMV to the newborn screening "blood spot" program — which includes more than 50 disorders — will help babies get a prompt diagnosis and treatment. For example, an antiviral medication called valganciclovir may improve hearing and developmental outcomes.

Last week, the Minnesota Advisory Committee on Heritable and Congenital Disorders met and recommended adding CMV to the program. Malcolm will make the "final determination," according to state health officials. While it's rare for a commissioner not to approve a committee recommendation, the Star Tribune Editorial Board nevertheless urges her to sign off expeditiously.

If that occurs, the state will be among the first in the nation, if not the first, to do universal screening for CMV. Other states should follow its lead.

Minnesota legislators merit praise for passing the "Vivian Act" in 2021, directing resources to raise CMV awareness among medical providers and parents. Lawmakers also directed the state advisory committee to swiftly take up the question of screening for congenital CMV. The law is named for Vivian Henrikson, a St. Paul girl who was born with CMV. The Editorial Board has previously supported the Vivian Act and adding CMV to the newborn screening program.

The University of Minnesota Medical School deserves praise, too. Its researchers contributed to the science that bolstered confidence in blood tests' ability to detect CMV. A study published last year found 86% sensitivity, which was "substantially higher" than had been reported before.

Doubts about the blood test picking up CMV likely prevented states from adding CMV to newborn screening programs before now. But the new data from the 2021 study is strong evidence of the test's reliability. Minnesota should lead the way on this important public health advance.

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